Micro-planning for immunization in Kaduna State, Nigeria: Lessons learnt, 2017

Umeh, Gregory; Madubu, Dauda M.; Korir, Charles; Nkwogu, Loveday; Ishaku, Sambo; Iyal, Hadiza Aliyu; Omoleke, Semeeh Akinwale; Nomhwange, Terna; Atiku, A; Musa, Audu; Dankoli, Raymond; Ningi, Adamu; Braka, Fiona; Dogo, Paul; Soba, Haliru; Iliyasu, Neyu

doi:10.1016/j.vaccine.2018.10.020

Cited by 11 publications

(8 citation statements)

References 19 publications

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“…Poor immunisation system performance often highlights underlying structural weaknesses in the health system in which it operates 29. Issues of poorly financed health systems,30 31 demotivated human resource for health32 and poor planning for immunisation within the wider context of the health system33 have been reported in Mali, Guinea and Nigeria as contributory to poor coverages and dropout. However, the above factors can only partially explain the poor performance in these countries, as other relatively well-performing countries in the subregion also grapple with similar challenges.…”

Section: Discussionmentioning

confidence: 99%

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

et al. 2019

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BackgroundSeveral West African countries are unlikely to achieve the recommended Global Vaccine Action Plan (GVAP) immunisation coverage and dropout targets in a landscape beset with entrenched intra-country equity gaps in immunisation. Our aim was to assess and compare the immunisation coverage, dropout and equity gaps across 15 West African countries between 2000 and 2017.MethodsWe compared Bacille Calmette Guerin (BCG) and the third dose of diphtheria–tetanus–pertussis (DTP3) containing vaccine coverage between 2000 and 2017 using the WHO and Unicef Estimates of National Immunisation Coverage for 15 West African countries. Estimated subregional median and weighted average coverages, and dropout (DTP1–DTP3) were tracked against the GVAP targets of ≥90% coverage (BCG and DTP3), and ≤10% dropouts. Equity gaps in immunisation were assessed using the latest disaggregated national health survey immunisation data.ResultsThe weighted average subregional BCG coverage was 60.7% in 2000, peaked at 83.2% in 2009 and was 65.7% in 2017. The weighted average DTP3 coverage was 42.3% in 2000, peaked at 70.3% in 2009 and was 61.5% in 2017. As of 2017, 46.7% of countries (7/15) had met the GVAP targets on DTP3 coverage. Average weighted subregional immunisation dropouts consistently reduced from 16.4% in 2000 to 7.4% in 2017, meeting the GVAP target in 2008. In most countries, inequalities in BCG, and DTP3 coverage and dropouts were mainly related to equity gaps of more than 20% points between the wealthiest and the poorest, high coverage regions and low coverage regions, and between children of mothers with at least secondary education and those with no formal education. A child’s sex and place of residence (urban or rural) minimally determined equity gaps.ConclusionsThe West African subregion made progress between 2000 and 2017 in ensuring that its children utilised immunisation services, however, wide equity gaps persist.

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Section: Discussionmentioning

confidence: 99%

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

et al. 2019

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“…The figures are, however, not reliable due to an underestimated denominator and data quality issues. 7 , 8 The poor immunization data quality increasingly makes the use of survey data more valuable for critical decision-making and immunization performance review.…”

Section: Discussionmentioning

confidence: 99%

An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria

et al. 2021

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Introduction: In 2019, we investigated the profile of the cases and controls and the determinants of pertussis transmission in Kebbi State, Northwestern Nigeria, to inform better immunization and surveillance strategies. Methods: Community-based unmatched case–control study and review of the 2019 pertussis routine surveillance data in the affected settlements in the state were conducted. A total of 52 suspected cases of pertussis and 107 control from two local government areas in Kebbi State were recruited. Data were analyzed using descriptive and inferential statistics. Results: The highest attack rate was observed among between 1- and 4-year age group followed by children less than 1-year old, and the least attack rate was among those above 15 years. The overall attack rate and the case fatality rate were 2.10% and 0.10%, respectively. A higher attack rate was observed among women, whereas the case fatality rate was more among males. From the community survey, we observed that the cases were less likely to have pertussis vaccination history (adjusted odds ratio = 0.28, 95% confidence interval = 0.11–0.74) compared with the controls. Knowing pertussis prevention methods were found protective for pertussis transmission (adjusted odds ratio = 0.14, 95% confidence interval = 0.04–0.45). Conclusion: This study showed the vulnerability of children under 5 years, especially under 1 year, to vaccine-preventable diseases in rural populations, where “real” immunization coverage is sub-optimal, and the dominant socio-demographic factors are supportive of disease transmission. We found immunization and knowledge of the preventive measures to be protective against pertussis outbreaks. Therefore, routine immunization services must be intensified to improve coverage and prevent future pertussis outbreak(s).

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“…A study conducted in Kaduna State, northwestern Nigeria showed that the projected census population that was used to compute RI denominator was fraught with errors and a gross underestimate of the target population (denominator) for RI when compared with a carefully conducted mini-census (ie, microplanning and walk-through). 17 Nevertheless, a scrutiny of the RI coverage trend for BCG, Penta 1, Penta 3, and measles from January to September 2019, depicted a bit of an undulating pattern. There was a modest increase in coverage during the months when SIAs rounds were integrated with routine immunization.…”

Section: Discussionmentioning

confidence: 99%

The Potential Contribution of Supplementary Immunization Activities to Routine Immunization in Kebbi State, Nigeria

Omoleke

Getachew

Igoh

et al. 2020

J Prim Care Community Health

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Background: Among the strategies of the Polio Eradication Initiative, the landmark interventions are routine immunization (RI) and supplementary immunization activities (SIAs). RI is the provision of vaccination service at the health facility and conducted year-round. SIAs are a community-based intervention targeting large numbers of an eligible population within a short period. Hence, the study aimed to assess the contributions of SIAs on access and utilization of RI services. Methods: We conducted the study in 10 local government areas in Kebbi State, northwestern Nigeria. We analyzed RI data from January to September 2019 and included the 4 SIAs conducted in January, April, August, and September in the same years. The number of children vaccinated, the trend of BCG, pentavalent vaccine at 6 and 10 weeks, and measles coverage and dropout rates (DORs) were analyzed. Results: For all the selected vaccines, the highest contributions to RI were recorded during the August 2019 fractional Inactivated Polio Vaccine (fIPV) campaign. On the other hand, the least contributions were noted during January SIAs. The BCG coverage showed an erratic trend with the lowest in February and highest in July 2019. The coverage for the pentavalent vaccine at 6 and 10 weeks was lowest in February and September. The pentavalent vaccine DOR pattern showed the lowest in February with value of 0% and the highest in June with 12%. Except for May and June, the Pentavalent vaccine DORs for all other months were <10%. February 2019 had the lowest measles coverage. Conclusion: Our study demonstrated that the integration of RI into SIAs could improve RI coverage. and potentially reduce DOR, especially when the integration is of good quality and conducted at short and regular intervals. Although SIAs are instrumental at increasing RI coverage, the disruption of RI services may occur due to overlapping resources and poor planning. Therefore, SIAs should be adequately planned by program managers to strengthen RI service delivery during the SIAs implementation.

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Micro-planning for immunization in Kaduna State, Nigeria: Lessons learnt, 2017

Cited by 11 publications

References 19 publications

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria

The Potential Contribution of Supplementary Immunization Activities to Routine Immunization in Kebbi State, Nigeria

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